RESUMO
BACKGROUND: To report one year results of the first cohort of routine refractive lenticule extraction through a small incision (ReLEx SMILE) for correction of myopia and myopic astigmatism. METHODS: Fifty-four eyes of 27 patients with spherical equivalent of -4.68 ± 1.29D who underwent routine ReLEx SMILE by a single surgeon were prospectively followed-up for 1 year. We used the VisuMax femtosecond laser system (Carl Zeiss Meditec AG, Germany) with a 500 kHz repetition rate. Folow-up intervals were at 1 day, 1 week, 1, 3, 6, and 12 months after surgery. We obtained following parameters: uncorrected (UDVA) and distance-corrected visual acuity (CDVA), contrast sensitivity, and wave front measurements. We also recorded all complications. RESULTS: Because of suction loss in one eye, 12-month results were obtained in 53 eyes as follows. After 1 year, 88% of eyes with plano target had an UDVA of 20/20 or better. Twelve percent of eyes lost 1 line of CDVA, while 31% gained 1 line and 3% gained 2 lines. The mean SE after 1 year was -0.19 ± 0.19. The mean refraction change between month 1 and 12 was 0.08 D. Neither mesopic nor photopic contrast sensitivity showed any significant changes. The high-order aberrations (HOA) increased from 0.17 to 0.27 µm (Malacara notation). No visually threatening complications were observed. CONCLUSION: In this first cohort, ReLEx SMILE produced satisfactory refractive outcomes with moderate induction of HOA and unaffected contrast sensitivity after 1 year.
Assuntos
Sensibilidades de Contraste/fisiologia , Cirurgia da Córnea a Laser/métodos , Aberrações de Frente de Onda da Córnea/fisiopatologia , Lasers de Excimer/uso terapêutico , Miopia/cirurgia , Complicações Pós-Operatórias , Acuidade Visual/fisiologia , Adulto , Astigmatismo/fisiopatologia , Astigmatismo/cirurgia , Substância Própria/cirurgia , Topografia da Córnea , Feminino , Humanos , Curva de Aprendizado , Masculino , Microcirurgia/métodos , Miopia/fisiopatologia , Estudos Prospectivos , Retalhos Cirúrgicos , Adulto JovemRESUMO
AIM: To compare 1-year results of the refractive lenticule extraction (ReLEx) flex technique performed as a commercial bilateral simultaneous procedure to a matched group of wavefront-optimized Femto-Lasik for correction of myopia and astigmatism with emphasis on contrast sensitivity and high-order aberrations (HOA). METHODS: In this retrospective study 44 eyes of 22 patients with spherical equivalent (SE) of -5.13 D who underwent ReLEx were matched to 50 eyes of 25 patients with SE of -5.42 D treated by wavefront-optimized Femto-Lasik. We used Carl Zeiss Meditec (CZM) VisuMax(®) femtosecond laser system with a 200 kHz repetition rate. In addition, for Femto-LASIK, MEL 80 Excimer Laser (CZM) with aspheric ablation profiles was used for ablation. RESULTS: At 1 year, the mean SE in the ReLEx group was -0.23 ± 0.35 D and in the Femto-LASIK group -0.15 ± 0.27 D. The mesopic contrast sensitivity of ReLEx treated eyes at 12 and 18 cpd improved from 1.49 and 0.99 to 1.54 and 1.1 respectively. In the Femto-LASIK group the numbers were pre-op 1.51 and 1.03, and after 1 year 1.54 and 1.06. The high-order aberrations (HOA) after ReLEx changed from 0.15 to 0.23 µm, and after Femto-LASIK from 0.175 to 0.320 µm (p = 0.0023). CONCLUSION: At 1 year, wavefront-optimized Femto-LASIK produced similar refractive outcomes to ReLEx(®) flex with better, but non-significant accuracy. In contrast, ReLEx(®) flex showed significantly less induction of HOA and better mesopic mid-term contrast sensitivity then the wavefront-optimized Femto-LASIK.